The Boston Globe reported today that Republicans will oppose Don Berwick’s nomination as the head of the Centers for Medicare and Medicaid Services (CMS) by accusing him of being “an advocate for rationing care.”

Nothing could be further from the truth.

In most industries, it is well accepted that the highest quality requires minimizing waste. However, in health care there has been a real divide between those who devote their careers to improving quality, and those who devote their careers to minimizing waste. That’s starting to change, and the Institute of Medicine defined quality as Safe, Timely, Effective, Efficient, Equitable and Patient Centered. That’s a good sign indeed.

Don Berwick is a pioneering prophet of quality who recognized early that controlling waste, and keeping health care affordable, is critical to quality. He has written (eloquently) aboutthe “triple aim” of improving the experience of care, improvingthe health of populations,and reducing per capita costs ofhealth care.” His organization, the Institute for Healthcare Improvement, has helped spread knowledge, best practices, and the gospel of reducing errors and complications to save lives (and money).

We clearly need a CMS Administrator who cares deeply about quality, and who also understands the centrality of reining in our out-of-control costs. It won’t be an easy job, because unnecessary costs in one person’s eyes are income to someone else. Don Berwick can do this job. We’re lucky he’s willing to try.

We must all agree that to guard our country's future financial health (and decrease the future deficit) we must control health care costs. Demagoguery accusing anyone who cares about costs of rationing, or death panels won't help.

WHETHERORNOTTHETRIPLEAIM is within reach for the UnitedStates has become less and less a question of technical barriers.From experiments in the United States and from examples of othercountries, it is now possible to describe feasible, evidence-basedcare system designs that achieve gains on all three aims atonce: care, health, and cost. The remaining barriers are nottechnical; they are political.